Provider Demographics
NPI:1396791836
Name:CHRISTINE M ROGERS PT INC
Entity type:Organization
Organization Name:CHRISTINE M ROGERS PT INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-942-8922
Mailing Address - Street 1:PO BOX 62183
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96839-2183
Mailing Address - Country:US
Mailing Address - Phone:808-942-8922
Mailing Address - Fax:808-942-8922
Practice Address - Street 1:460 ENA RD
Practice Address - Street 2:607
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1779
Practice Address - Country:US
Practice Address - Phone:808-942-8922
Practice Address - Fax:808-942-8922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2008-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT995225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIZ1213OtherQUEENS HEALTH CARE PLAN
HIB81014OtherBCBS/HMSA
HIZ1213OtherQUEENS HEALTH CARE PLAN